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Nagorno-Karabakh: Tackling a Legacy of Stigmatisation

12 July 2019
Photo of patients of the Lady Cox Rehabilitation centre in Nagorno-Karabakh taken during our 2019 visit.

Soviet attitudes towards disabilities:

The Soviets’ mentality towards those with disabilities continues to shape discourse and policies, and the experience of those with disabilities in the region today. The Soviets glorified the human form, but only within a strict set of criteria, and those who didn’t meet this were deemed as ‘other’ or as ‘invalids’. Such ideals were exemplified through the commitment to physical training and cultural means such as Stalinist art.

Disabled people were viewed as undermining Soviet ideals and the cultivated image of a ‘state of happiness’, so much so that it was once declared by a Soviet representative that “There are no invalids in the USSR!” Such attitudes meant that not only were there limited facilities available to them, but those with disabilities were kept out of the public eye as much as possible leading them to isolated lives in the shadows. Mothers were often blamed for their children’s disabilities, and so were not offered the support they needed. Simi Linton summarised this by saying that ‘society would not tolerate being bogged down by those who couldn’t keep up, who are thought to drain resources, or who reminded us in any way of the limitations of our scientific capabilities’.

The disregard towards, and at times complete denial of, those with disabilities was so ingrained within Soviet society, that these attitudes can even be seen reflected in infrastructure. Only able-bodied people were valued, and so only their needs were served. The vast majority of the uniform apartment buildings had no elevators at all or if they did, their entrances were too small for a wheelchair to fit through.

“We were given a label [invalid” in Russian and Ukrainian], a pension, and a license to do nothingdescribed one disabled Ukrainian activist. The idea of being an ‘invalid’ was seen not as one aspect of someone’s identity and a condition that could be improved, rather it was viewed as a state of being.

The impact of this today in Nagorno-Karabakh:

As an ex-Soviet state, there remains a legacy of the stigmatisation of disability in Nagorno-Karabakh. The problems caused by this are compounded by the fact that Nagorno-Karabakh is a de facto state and not internationally recognised; it therefore struggles to access international channels for funds to provide fundamental services including health and social care.

Vardan Tadevosyan, Director of the Lady Cox Rehabilitation Centre, summarises this by saying that ‘HART support is really very essential, because our country is not recognised. International donors are interested in what we are doing but they are not able to help because of the political situation.

Internationally, few people have heard of the region Nagorno-Karabakh, or their struggles providing these services. Unsurprisingly, funds therefore tend to be focused on better publicised humanitarian struggles such as those happening in Syria.

HydrotherapyPool

Hope for the future

The Lady Cox Rehabilitation Centre is the only facility of its type in the whole South Caucus region, and therefore provides invaluable therapy and assistance to individuals with disabilities and their families. There is a wide range of therapies available, including speech therapy, physiotherapy and hydrotherapy. The centre crucially also works to tackle the stigma surrounding disability. They do this through demonstrating that through hard work, and with adequate support, those with disabilities can become active members of society. They also have specific strategies aimed at tackling the stigma head on, for example in the day centre, there are equal numbers of spaces available for children with disabilities and those without. Through this increased interaction, it is hoped that the next generations will form friendships, and better understand the value that those with disabilities can add to our society.

The centre is now recognised by the Nagorno-Karabakh government who provide a large proportion of the funding. It employs 60 nurses and helps 1000 people each year. The ‘Centre of Excellence’ provides tailored, high-quality care at no cost at all to the patients. However, Vardan estimates that only 1/10th of those needing help are receiving it, and highlights the long waiting lists for non-priority patients. The ongoing challenge is how to expand its services to reach as many people as possible, as well as replicating the model both elsewhere in the region, and further afield.

By Loretta Sargeant

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